口腔医学研究

口腔医学研究 ›› 2024, Vol. 40 ›› Issue (11): 1004-1008.DOI: 10.13701/j.cnki.kqyxyj.2024.11.011

• 口腔颌面外科学研究 • 上一篇    下一篇

纤维内镜在累及舌根的舌癌患者术后吞咽功能评估中的临床应用

朱越1, 钱晓云2, 衡伟伟1, 孙国文3*   

  1. 1.南京大学医学院附属口腔医院,南京市口腔医院耳鼻咽喉科,南京大学口腔医学研究所 江苏 南京 210008;
    2.南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科,南京鼓楼医院耳鼻咽喉研究所 江苏 南京 210008;
    3.南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,南京大学口腔医学研究所 江苏 南京 210008
  • 收稿日期:2024-05-28 出版日期:2024-11-28 发布日期:2024-11-27
  • 通讯作者: *孙国文,E-mail:238957@sina.com
  • 作者简介:朱越(1990~ ),女,南京人,硕士,主治医师,研究方向:头颈部恶性肿瘤。
  • 基金资助:
    南京市卫生科技发展专项资金项目(编号:YKK22183)南京大学医学院附属口腔医院3456骨干人才资助项目(编号:0222C111)

Application of Fiberoptic Endoscopic on Evaluation of Swallowing Function in Patients with Tumors Involving Both Oral Tongue and Base of Tongue

ZHU Yue1, QIAN Xiaoyun2, HENG Weiwei1, SUN Guowen3*   

  1. 1. Department of Otolaryngology Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China;
    2. Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, Medical School, Nanjing University, Nanjing 210008, China;
    3. Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China
  • Received:2024-05-28 Online:2024-11-28 Published:2024-11-27

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摘要： 目的: 探讨纤维内镜评估吞咽功能(fiberoptic endoscopic evaluation of swallowing, FEES)在累及舌根的舌癌(both the oral tongue and the base of the tongue, OBOT)患者中的临床应用。方法: 对2022年4月至2023年5月于我院初诊为累及OBOT病变的患者术前、术后1周、1月和1年进行吞咽功能评估。吞咽功能的评估包括MD安德森吞咽困难量表(MD Anderson Dysphagia Inventory, MDADI)、华盛顿大学生活质量问卷(University of Washington Quality-of-Life Questionnaire, UW-QOL)、头颈癌表现状态量表(Performance Status Scale for Head and Neck Cancer, PSS-HN)、洼田饮水试验(water swallow test, WST)、舌运动测量和FEES[包括渗透-吸入量表(Penetration-Aspiration Scale, PAS)和口咽吞咽效率(oropharyngeal swallowing efficiency, OPSE)]。并对FEES的评估OBOT的可靠性进行统计分析。结果: 共有21例患者纳入研究。FEES具有较高的诊断价值(ROC曲线下面积=0.916)。FEES结果与WST和MDADI评分显著相关(P<0.001)。术后1年,累及OBOT病变患者的吞咽功能恢复到术前水平,但OPSE明显下降,生活质量仍受影响(P<0.001)。结论: FEES是评估累及OBOT病变患者术后吞咽功能的可靠方法,值得临床推广。在术后随访中,虽然这些患者的吞咽功能可以恢复,但应注意吞咽效率和生活质量。

关键词: 舌肿瘤, 舌根肿瘤, 纤维内镜检查, 吞咽障碍

Abstract: Objective: To investigate the clinical application of fiberoptic endoscopic on evaluation of swallowing (FEES) and the recovery of swallowing function in patients with lesions involving both the oral tongue and the base of the tongue (OBOT). Methods: Patients diagnosed with OBOT lesions between April 2022 and May 2023 underwent assessments preoperative and at 1 week, 1 month, and 1 year after surgery. The evaluation of swallowing function included the MD Anderson Dysphagia Inventory (MDADI), University of Washington Quality-of-Life Questionnaire, Performance Status Scale for Head and Neck Cancer, water swallow test, tongue motion measurement, and FEES (Penetration-Aspiration Scale, oropharyngeal swallowing efficiency). The reliability of the evaluation of OBOT by FEES was statistical analyzed. Results: In total, 21 patients participated in this study. FEES had high diagnostic value (area under the curve=0.916). FEES parameters were significantly correlated with the results of the water swallow test and MDADI scores (all P<0.001). The swallowing function of patients with OBOT lesions returned to the preoperative level at 1 year postoperatively, but the oropharyngeal swallowing efficiency decreased significantly, and the quality of life was still affected (all P<0.001). Conclusion: FEES is a reliable method for evaluating the postoperative swallowing function of patients with OBOT lesions and is worthy of clinical promotion. In postoperative review, although the swallowing function of these patients was restored, attention should be paid to the swallowing efficiency and quality of life.

Key words: tongue tumor, base of tongue tumor, laryngoscopy, deglutition disorders